영국 NHS의 모성서비스 관련 의료과오보상제도의 경험과 그 함의

다국어 초록 (Multilingual Abstract)

Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60–70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver’s capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK’s experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

목차 (Table of Contents)

• I. 서론
• 1. 연구 배경
• 2. 연구목적 및 방법
• II. 영국의 의료체계
• III. 영국의 의료과오보상 현황
• IV. 영국의 의료과오보상체계
• 1. The NHS Litigation Authority (국가보건서비스 소송국: NHSLA)
• 2. NHS redress scheme (국가보건서비스 구제제도)
• V. NHSLA의 모성서비스관련 의료과오 보상사례
• VI. 고찰 및 결론
• 참고문헌
• ABSTRACT

참고문헌 (Reference)

1 권병기, "치과임상영역에서 발생된 의료분쟁의 판례분석" 대한안면통증∙구강내과학회 31 (31): 283-296, 2006

2 김용욱, "진료과오에 있어서 의사의 주의의무" 26 (26): 1983

3 이재형, "의료사고의 피해자구제에 관한 연구" 한양대학교 대학원 2007

4 박종권, "의료과오에서 의사의 주의의무" 7 : 2007

5 이종인, "의료과오에 있어서의 배상책임에 관한 법경제학적 고찰" 한국법경제학회 6 (6): 255-269, 2009

6 김민규, "우리나라 의료과오소송의 실태와 의료분쟁해결방안" 한국비교사법학회 10 (10): 235-276, 2003

7 "http://www.publications.parliament.uk/pa/ld200506/ldbills/022/2006022.pdf"

8 "http://www.nhsla.com/home.htm"

9 "http://www.nhsla.com/Claims/Schemes/CNST/"

10 Department of Health, "The new NHS" Stationery Office 1997

11 Secretary of State for Health, "The new NHS" Stationery Office 1997

12 Dineen M, "The management of clinical negligence litigation by NHS Trusts and their legal advisors" 6 : 62-66, 2000

13 Capstick B, "The future of clinical negligence litigation?" 328 (328): 457-459, 2004

14 Pharoah POD, "The changing epidemiology of cerebral palsy" 75 : F169-F173, 1996

15 The National Health Service Litigation Authority, "THE NATIONAL HEALTH SERVICE LITIGATION AUTHORITY" 2010

16 Clements RV, "Review Litigation in gynaecology" 3 : 70-74, 2003

17 Comptroller, "Report of the Comptroller and Auditor General in NHS (England) Summarised Accounts 1995 –-96" The Stationery Office 1997

18 "National Health Service Litigation Authority (NHSLA)"

19 Dyer C, "NHS to settle small compensation claims without litigation" 331 (331): 923-, 2005

20 Argent V.P., "Medico-legal problems in gynaecology" 16 (16): 289-294, 2006

21 Kennedy I, "Medical law" Butterwortths 2000

22 Annas GJ, "Medical Malpractice Litigation under National Health Insurance: Essential or Expendable?" 1975 (1975): 1335-1373, 1976

23 Ham C, "Managed markets in health care: the UK experiment" 35 : 279-292, 1996

24 Vijh R, "Malpractice litigation in patients in relation to delivery of breast care in the NHS" 17 : 148-151, 2008

25 Department of Health, "Making Amends: a consultation paper setting out proposals for reforming the approach to clinical negligence in the NHS" DoH 2003

26 Clark K, "Litigation: a threat to obstetric practice?" 9 (9): 303-322, 2002

27 Alderman B, "Litigation in obstetrics and gynaecology has increased in Merseyside (letter)" 314 : 1997

28 Symon A, "Litigation and defensive clinical practice: quantifying the problem" 16 (16): 8-14, 2000

29 Le Grand J, "Learning from the NHS internal market: a review of the evidence" King's Fund 1998

30 Bojke C, "Is bigger better for primary care groups and trusts?" 322 : 599-602, 2001

31 Wall A, "Health policy" Routledge 2002

32 Montgomery J, "Health care law" Oxford University Press 2003

33 Higgins J, "Health Policy: A new look at NHS commissioning" 334 (334): 22-24, 2007

34 Ham C, "Health Policy in Britain" Palgrave 2004

35 The National Health Service Litigation Authority, "Factsheet 2: financial information"

36 NHS Litigation Authority, "Fact sheet 3: information on claims" NHSLA 2003

37 Robinson R, "Evaluating the NHS reforms" King's Fund 1994

38 Dobson, F, "Dobson to tackle rising le6els of litigation in the health ser6ice" DH Press 1998

39 Cooper JB, "Current research on patient safety in the United States" National Patient Safety Foundation 2001

40 Cole A, "Clusters of primary care trusts will oversee transition to new NHS" 341 : c7286-, 2010

41 Bush L, "Clinical Negligence Scheme for Trusts for maternity services (CNST)" 13 (13): 373-376, 2003

42 Nair V, "Clinical Negligence Scheme for Trusts (CNST) Obstetrics" 20 (20): 125-128, 2010

43 Hagberg B, "Changing panorama of cerebral palsy in Sweden. VIII. Prevalence and origin in the birth year period 1991-94" 90 : 271-277, 2001

44 Gaffney G, "Cerebral palsy and neonatal encephalopathy" 70 : F101-F200, 1994

45 Catherine Greenwood, "Cerebral palsy and clinical negligence litigation: a cohort study" 110 (110): 6-11, 2003

46 "Capital and Counties plc v Hampshire CC and others"

47 "CNST maternity standards"

48 Department of Health.(DoH), "Building a safer NHS for patients – implementing An organisation with a memory" DoH 2001

49 Goddard M, "Assessing the performance of NHS Hospital Trusts: the role of ‘hard' and ‘soft' information" 48 : 119-134, 1999

50 Department of Health, "An organisation with a memory" DoH 86-, 2000

51 National Audit Office (NAO), "A safer place for patients: Learning to improve patient safety" NAO 2005